Coupled Gluteus Maximus and Gluteus Medius Recruitment Patterns Modulate Hip Adduction Variability During Single-Limb Step-Downs: A Cross-Sectional Study.

CONTEXT Examining the coordinated coupling of muscle recruitment patterns may provide insight into movement variability in sport-related tasks. OBJECTIVE The purpose of this study was to examine the relationship between coupled gluteus maximus and medius recruitment patterns and hip-adduction variability during single-limb step-downs. DESIGN Cross-sectional. SETTING Biomechanics laboratory. PARTICIPANTS Forty healthy adults, including 26 women and 14 men, mean age 23.8 (1.6) years, mean body mass index 24.2 (3.1) kg/m2, participated. INTERVENTIONS Lower-extremity kinematics were acquired during 20 single-limb step-downs from a 19-cm step height. Electromyography (EMG) signals were captured with surface electrodes. Isometric hip-extension strength was obtained. MAIN OUTCOME MEASURES Hip-adduction variability, measured as the SD of peak hip adduction across 20 repetitions of the step-down task, was measured. The mean amplitudes of gluteus maximus and gluteus medius EMG recruitment were examined. Determinism and entropy of the coupled EMG signals were computed with cross-recurrence quantification analyses. RESULTS Hip-adduction variability correlated inversely with determinism (r = -.453, P = .018) and positively with entropy (r = .409, P = .034) in coupled gluteus maximus/medius recruitment patterns but not with hip-extensor strength nor with magnitudes of mean gluteus maximus or medius recruitment (r = -.003, .081, and .035; P = .990, .688, and .864, respectively). CONCLUSION Hip-adduction variability during single-limb step-downs correlated more strongly with measures of coupled gluteus maximus and medius recruitment patterns than with hip-extensor strength or magnitudes of muscle recruitment. Examining coupled recruitment patterns may provide an alternative understanding of the extent to which hip neuromuscular control modulates lower-extremity kinematics beyond examining muscle strength or EMG recruitment magnitudes.